Resistant Hypertension in Chronic Kidney Disease

184

Chronic Kidney Disease in the Elderly

Aging is associated with a progressive decrease in glomerular filtration rate. Indeed,
the “physiological” loss of glomerular filtration rate has been quantified as a loss of
1 ml/min per year. However, the rate of loss of glomerular filtration rate is very vari-
able: some individuals display stable glomerular filtration rate over the years, while
some lose glomerular filtration rate at a faster rate and develop chronic kidney dis-
ease [ 3 ].
In this regard, the prevalence of chronic kidney disease increases with age
(Fig. 12.2) [ 4 ]. Most elderly individuals with chronic kidney disease have not been
diagnosed. However, the prevalence of chronic kidney disease is around 60% for
those aged 80 years or older. Thus, population studies in such elderly individuals

4.6 7.2 9.4

65-7 47 5-79 >– 80

%

years yearsyears

% %

60

37 % 48 % %

A) Known CKD

B) Unknown CKD

Fig. 12.1 Chronic kidney
disease: underdiagnosed in
the elderly (Elaborated
from data obtained from
Stevens et al. [ 4 ]). (A)
Percentage of individuals
with known CKD. (B)
Percentage of individuals
with undiagnosed CKD

Spanish r

esiden

ts

85-year-

old or

older (number)

0

200000

400000

600000

800000

1000000

1200000

1400000

2002 2015

Fig. 12.2 The elderly population is rapidly increasing (Elaborated with official data from the
Spanish National Statistics Institute (Instituto Nacional de Estadística, INE) [ 23 ])

R. Fernández-Prado et al.